Please note that all samples for urine microbiology should be sent to Synnovis in containers with boric acid. The addition of boric acid helps to prevent growth of contaminants and leads to more accurate test results.

GPs in Southwark and Lambeth, therefore, should continue to use green top Monovette tubes for mid-stream urine (MSU) samples.

However, GPs in Bromley, Bexley, Greenwich and Lewisham should use red top boric acid containers. GPs in these boroughs no longer have access to green top Monovette tubes and should not use white top universal containers for MSU samples.

White top universal containers should continue to be used for any non-microbiology urine samples.

The consumables ordering portal here has been updated to reflect the above changes.

Please note that, from 1 January 2023, Synnovis no longer accepts MSU samples in universal white top containers.

HbA1c – cessation of dual reporting

Haemoglobin A1c (HbA1c) is glycosylated haemoglobin, ie haemoglobin that has glucose bound to it. The amount is directly related to an individual’s glucose levels over the previous two to three months, making it a better overall indicator of average glucose than a single snapshot glucose measurement.

To date, Synnovis has continued to report HbA1c using both the historical Diabetes Control and Complications Trial (DCCT) measurement as a percentage of total haemoglobin, and the newer standardised International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) method as a ratio of HbA1c to non-glucose bound haemoglobin, reported as mmol/mol.

Feedback from primary and community care colleagues has told us that dual reporting is not only time-consuming to process and file, but that it adds no benefit to patient care. As a result, we are in the process of moving to reporting only the IFCC-preferred units of mmol/mol.

We are also reviewing the clinical comments we provide for HbA1c results to streamline them across all south east London boroughs.

Please let us know about any other aspects of clinical guidance that you feel would be helpful, by either speaking to your GP clinical leads or to our Customer Services team.

Synnovis’ monthly potassium audit, which assesses the trending of samples analysed for raised potassium levels as a result of delayed testing, has been showing a consistent downwards trend following a series of improvements to our preanalytical specimen pathway. 

Since the start of the 2022, we have worked to improve our service to reduce the risk of delays, preserve sample integrity and inhibit the risk of samples being subject to raised levels of potassium.

This has been part of a continuous service improvement strategy, beginning with phlebotomy and including specimen transport and sample preparation to ensure our processes are as efficient as possible.

We worked with our transportation provider to alter routes to ensure faster collections, recruited more staff to our specimen reception team, worked with practices to explore and resolve any issues, and implemented measure to ensure the stabilisation of sample temperatures.

We will continue to audit and monitor this issue and to work with practices to ensure we can improve further when needed.